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NORTH BAY/BIOSCIENCE, LLC

METHODS OF STERILIZATION
There are four sterilization methods used in medical and dental offices:

1. Steam (autoclave) sterilization


2. Chemical vapor sterilization
3. Dry heat sterilization
4. Ethylene oxide gas sterilization

Each of these methods, when used properly, will achieve sterilization. Effective sterilization is depen-
dent upon the ability of the sterilant (e.g., saturated steam, heat or gas) to have direct contact with all
surfaces of the device or product being sterilized, for a specified time at a set temperature. Proper tech-
niques in cleaning, preparation, packaging, and placement of supplies in the sterilizer chamber are
critical for successful sterilant contact.

Steam sterilization
Moist heat in the form of saturated steam under pressure is the sterilant used in the steam sterilizer
(autoclave). Steam sterilization is the least time consuming, and the preferred, method of sterilization
for heat and moisture stable medical devices. In steam sterilization it is important that the ambient air in
the chamber and contents be completely removed at the beginning of the cycle so that the saturated
steam can have direct contact with the items being sterilized. There are three main types of steam steril-
ization cycles: gravity, pre-vacuum, and flash.

In the gravity cycle, air is displaced by steam entering the chamber. In the pre-vacuum cycle, air is
removed very quickly by mechanical means. The flash cycle is for quickly sterilizing unwrapped medical
devices that are to be used immediately after sterilization. The flash cycle can use either gravity or pre-
vacuum air removal. Flash sterilization is intended only for emergencies where an instrument is needed
immediately (e.g. dropped instrument). It is not intended as a primary method of sterilization.

Chemical vapor sterilization


Unsaturated chemical vapor (a mixture of alcohol, water, ketones, and formaldehyde heated under
pressure) is a typical sterilant used in this method of sterilization. Because of the low moisture content
of unsaturated chemical vapor, it will not cause rust and corrosion on carbon steel instruments. Chemi-
cal vapor sterilization requires proper ventilation for post-cycling fumes. Formaldehyde has been shown
to be a carcinogen; therefore, as with all chemicals employed in your practice, users must follow strict
OSHA standards to protect employees and patients from exposure.

Dry heat sterilization


Hot air is the sterilant used in the dry heat sterilizer (hot air oven). It is a slow process because it
depends upon higher temperatures to incinerate microorganisms. This method of sterilization is used
for heat-stable, moisture-sensitive, or steam impermeable medical devices and products. The Cox dry
heat sterilizer is a rapid cycle dry heat sterilizer and is typically run for six minutes at 375°

Ethylene oxide sterilization


Ethylene oxide (EtO) is the sterilant used for gas sterilization. This method of sterilization is used for
heat-sensitive items. OSHA has concluded that exposure to EtO can increase the risk of serious
adverse health effects, including cancer and reproductive health hazards. Users must comply with
OSHA standards in order to reduce the risks of worker exposure to EtO. EtO sterilization process is
seldom used in office-based practice because of the long sterilization and aeration times required.

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